MR. KERRY COOPER CASAC NPI 1710056726

NPI Information

NPI: 1710056726
Provider Name: MR. KERRY COOPER, CASAC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
3584 JEROME AVE
BRONX, NY
ZIP 10467
Phone: (718) 653-1537
Get Directions

MR. Kerry Cooper, CASAC is an addiction (substance use disorder) counselor in Bronx, NY. MR. Kerry Cooper, CASAC NPI is 1710056726. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3584 JEROME AVE
BRONX, NY
ZIP 10467-006
Phone: (718) 653-1537
Fax: (718) 882-1426

The enumeration date for this NPI number is 11/6/2006 and was last updated on 3/13/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	12174	NEW YORK	No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)		NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01420795	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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